Antibiotic Resistant Bacteria, antimicrobials, bacterial disease, Biological Health Hazard, Category B - Bioterrorism Agents, CDC, community acquired, current-events, Elizabethkingia anophelis, environment, health, immig, Immigration Health Hazard, medicine, mosquito borne disease, mysterious disease, nature, pathogenic microbes, public health risk, Radiation exposure, State of Wisconsin, Water-related Hygiene, Zoonotic Infectious Diseases
Biological Health Hazard – Elizabethkingia anophelis (fatal): Wisconsin (Update 2016-06-22)
ELIZABETHKINGIA ANOPHELIS – USA (18): (WISCONSIN) FATAL, COMMUNITY ACQUIRED
Published Date: 2016-06-22 21:46:57
Subject: PRO/EDR> Elizabethkingia anophelis – USA (18): (WI) fatal, community acquired
Archive Number: 20160622.4302947
Date: Monday, 20 June 2016
Source: Healio [edited]
The CDC is still trying to determine why dozens of patients in the Midwest were recently sickened by a rare bloodstream infection caused by the _Elizabethkingia anopheles_ bacterium. “We are still looking for the missing piece,” Maroya S. Walters, PhD, ScM, epidemiologist at the CDC, said at ASM Microbe.
In the largest identified _Elizabethkingia_ outbreak in history, 66 patients in Wisconsin, Michigan and Illinois — most of them older adults — have been infected with the same strain of _E. anopheles_. 63 of these cases occurred in Wisconsin [plus 4 cases where the isolate was not available for genetic analysis – Mod.LL], where the outbreak began last November 2015 and peaked in February 2016. Under increased surveillance, isolates in 11 other states have tested positive for _Elizabethkingia_ — half of them for _E. anopheles_ — but none have matched the outbreak strain, Walters said.
_Elizabethkingia_ bacteria — named for Elizabeth O. King, the CDC bacteriologist who discovered it — are commonly found in the environment in soil, river water and reservoirs. They do not typically cause illness in humans, though Walters said the outbreak investigation revealed that infection is more common than previously thought.
All but one of the patients infected during the outbreak had a serious underlying medical condition, and 32% (n = 21) have died. The median age of the patients was 72 years, 47% (n = 31) were female and 97% (n = 64) were white. The outbreak occurred mostly in a community setting, with 66% (n = 40) of the patients living in a private residence at the time of their initial specimen collection. The most common symptoms were weakness and shortness of breath, Walters said.
Walters said the CDC has not found a source of contamination in health care products, hospitals, food, personal care products, or in patients’ homes, nor has the agency discovered evidence of patient-to-patient transmission. She said the CDC is continuing its search by conducting focus groups among patients who have closely related isolates, who live in the same town, or who share the same occupation, but she said that the investigation might soon end.
“We’re likely coming to the end of the active component of our investigation,” Walters told Infectious Disease News. “We’re doing focus groups to see if we can identify another likely hypothesis because we’d like to find the source of this outbreak, but also because we don’t know if this will come back, and if it does, we’d like to have more hypotheses to test. But once we feel like we are at baseline and we’ve been at baseline for several weeks, it will be the Wisconsin Department of Health Services’ decision whether or not to call off the active part of the investigation.”
[Byline: Gerard Gallagher]
ProMED-mail from HealthMap Alerts
[It remains curious that surprisingly little more information is known:
– no information has come out regarding the timeline of cases as to date of onset of illness and location;
– no additional information has been released regarding the recently reported, but older, outbreak of a genetically different strain of _E. anophelis_ in Illinois.
No new cases have been reported in Wisconsin this week (https://www.dhs.wisconsin.gov/disease/elizabethkingia.htm). – Mod.LL
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/250.]
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